AUBF Flashcards
Asahina, a registered medical technologist, is suspecting presence of oval fat bodies and fat droplets in a urine specimen. What stain must she use to demonstrate presence of
these sediments?
Sudan III stain
Presence of B-hydroxybutyric acid in urine specimen will give you what result on Rothera’s test?
No purple ring formed: it should not contain keto group (according
sa internet
How many hours of sexual abstinence should the patient observe prior to specimen collection?
48 to 120 hours
Which of the following tests for proteins is not based on denaturation and precipitation of proteins in urine?
Reagent strip test
All of the following can cause xanthochromia in CSF except?
: Increased numbers of white blood cells
What is the specific gravity of an isosthenuric urine on consecutive urinalysis?
: 1.010
Which of the following terms indicate the presence of blood in urine?
hematuria
What is the confirmatory test for elevated alpha-fetoprotein?
Amniotic acetylcholinesterase
What is the confirmatory test for elevated alpha-fetoprotein?
Amniotic acetylcholinesterase
What type of proteinuria occurs after several hours of prolonged standing?
orthostatic
What urine analyte is detected by reagent strips using Greiss reaction?
nitrite
What is the best method of preserving urine specimens for analysis?
Refrigeration
Which of the following artifacts is the most commonly found in urine and other body fluids & is characterized as having a dimple center?
Starch granules
On macroscopic examination of the physical characteristics and pH of the seminal fluid specimen of a 32 year old male, the following results were obtained:
Liquefaction: coagulation did not occur
Color: white
Viscosity: watery
Volume: 4.0 ml
pH: 7.2
Which of the above results s/are not normal?
Viscosity and liquefaction
Elevated level of adenosine deaminase in pleural fluid suggests what disease?
tuberculosis
All of the following can result in inaccurate urine pH measurements using reagent strip EXCEPT:
Choices are: double dipping of the reagent strip into the specimen &
Maintaning the specimen at room temperature for 4 hours
A medical technologist performed a STAT microscopic urinalysis and reported the following:
WBC: 10-13/hpf
RBC: 2-6/hpf
Hyaline Cast: 5-7/lpf
Bacteria: 1+
The urine sediment was not discarded and was reexamined microscopically 5 hours after the results were reported. A second technologist reported the same results, except
2+ bacteria and no hyaline cast were found. The most probable explanation for the second technologist’s findings:
Cast dissolved due to increase urine pH
A midstream clean-catch urine is submitted to the laboratory for routine urinalysis and bacterial culture. The routine urinalysis is done first, and 3 hours later, the specimen
is sent to the microbiology department for culture. As the medical technologist on duty, what is your course of action for the said specimen?
Reject it due to time delay and contamination
After a successful lumbar tap, what department is tube labeled 2 routinely sent to?
Microbiology
What cast indicates the mildest renal damage and a few being found after strenuous physical exertion?
hyaline cast
Which of the following is NOT a characteristic of the recommended urine containers?
snap-on lid
What is the single most important measure of semen quality?
Sperm motility
What is the purpose of boiling the urine until the volume is reduced to 10 ml in Hart’s test?
removal of acetone & acetoacetic acid
What urine analyte has the longest time frame of reaction in a reagent strip?
leukocyte esterase
Which of the following chemical tests will not detect bilirubin & bile pigments in urine?
Acetest Tablet test
A 52-year-old man has painful swelling in both knees. He is hospitalized and an arthrocentesis is scheduled for the following morning. In the morning, a fasting blood sugar
is drawn for routine chemistry tests. Synovial fluid is aspirated from the left knee and submitted to the laboratory.
Blood Chemistry results:
fasting glucose – 85 mg/dL
uric acid – 12.7 mg/dL
Synovial fluid results:
Appearance: cloudy, yellow
Viscosity: low
Microscopic analysis: many intracellular needle-shaped crystals with negative birefringence (yellow)
Glucose: 55 mg/dL
Uric acid: 12.4 mg/dL
Gram stain: negative
The above results are most consistent with a diagnosis of which of the following disorders?
gouty arthritis
Salt and acetic test performed on urine of a 30 year old woman yields Positive (2+) result, what is the exact description of the result?
Precipitates is ¼ - ½ of solution
What does it mean if the microscope used has a higher numerical aperture?
Better light-gathering capacity of the lens
Which of the following solutions should NOT be used to clean the microscope lenses?
distilled water
Approximately 75% of the renal calculi that form in patients contain which of the following substances?
calcium
Why do we have to remove the reagent strip immediately from the specimen?
to avoid run-over between pads
Based on what you had learned, the kidneys play an important role in which of the following functions?
1) Excretion of waste products
2) Maintenance of acid-base equilibrium
3) regulation of water & electrolyte balance
4) control of blood pressure & fluid balance
all are correct
What is the pH of a normal seminal fluid?
7.2-8.0
Robe Villegas, a middle aged man had several episodes of unbearable headaches after surviving a terrible fall. Recently, his physician requested for CSF analysis. His
laboratory results showed:
Total CSF Protein: 30 g/dL
CSF Lactate: 27 mg/dL
Predominant cell in differential count: macrophages with remnants of RBCs
Based on the laboratory results and history of patient, what specific disorder does patient Robe have?
intracranial hemorrhage
Which of the following should be done to preserve the integrity of the reagent strips?
Store in a tightly capped container
Pathologic accumulation of serous fluid in a body cavity is called
effusion
Calculate the total sperm count given the following information.
sperm cells counted in 5 RBC squares of hemocytometer= 35
Dilution= 1:20
semen volume= 4 mL
140 million sperms/mL
What should be done to a pregnancy test result when the lines developed are very faint or light?
It should be reported as positive
A 3 ml seminal fluid is submitted to the laboratory for sperm count. The medical technologist counted 443 sperm in 2 WBC squares. The sample is diluted 1:20. Compute
for the sperm cells per ejaculate count
132,900,000
Which of the following crystals is considered non-pathologic?
ammonium biurate
The chemical principle employed by reagent strips for detection of glucose is?
Glucose oxidase reaction
Which of the following results in a reagent strip signifies that the patient has hemolytic disorders?
positive urobilinogen
Arielle, a licensed medical technologist, received a slightly hazy urine specimen that turned black upon standing. It has a specific gravity of 1.030 and has easily
disappearing foam observed. What is the major concern regarding this sample?
color
A technologist observes a 1+ protein reaction on the dipstick when performing a routine urinalysis. What should the technologist do?
Confirm the result using sulfosalicylic acid
Which of the following urinary crystals-description pairs is NOT correctly matched?
Calcium phosphate – coffin-lid shape
For an accurate evaluation of CSF glucose, a blood glucose test must be run for comparison. When should the Medical Technologist draw blood for glucose determination?
2 hours before lumbar tap
What is the clarity of a well-mixed urine specimen that has visible particulate matter & through which newsprint can be seen but not read
Cloudy
How much urine specimen is required for Pettenkofer test?
2 mL
Which of the following test results with Iodine indicates presence of increased amount of urobilin in urine?
Greenish fluorescence
A red orange to brick red solution was formed after performing Benedict’s test on urine sample. It was graded 4+ by a MedTech, what is the estimated concentration of
glucose in the urine?
> 2 g%
Which of the following might cause the urine to be cloudy?
1. white blood cells
2. bacteria
3. non-squamous epithelial cells
4. hemoglobin
Bacteria
During microscopic examination of urine sediments, how can you tell that the pH of urine is acidic?
There are amorphous urates and/or uric acid
5-HIAA is a degradation product of ?
serotonin
All of the following diseases could cause a positive result for urine glucose except?
Osteoarthritis
Sperm motility evaluation is routinely performed when?
within 1 hour of collection
What is the reference value for CSF lactate?
10-24 mg/dL
Which of the following renal disorders frequently occurs following a bacterial infection of the skin or throat?
acute glomerulonephritis
What would be the implication of delayed delivery and analysis of urine specimen?
decreased glucose concentration
Which of the following methods does not measure urine specific gravity?
Spectrophotometry
A medical technologist will perform a sperm count but while preparing he/she noticed that the diluting reagent is not available. What is the best substitute for the diluting
fluid?
Cold water
Spermatogenesis occurs in the seminiferous tubules but where does development of flagella takes place?
Epididymis
What crystal is described as a sphere covered in spicules?
ammonium biurate
What condition is characterized by excretion of porphyrins in urine that makes the urine appear dark red or purple? This condition is also referred to as the origin of the
legend of vampires in Romania.
porphyria
A spike in 450 nm was observed after an amniotic fluid is subjected to spectrophotometry. What does it indicate?
Fetus is suffering from HDN.
Presence of urobilinogen in urine produces which of the following results with Ehrlich’s reagent?
Magenta color
Which of the following feature is NOT a distinguishing characteristic of yeast?
motility
If urine develops yellow foam on top when it is shaken, what abnormal test result could be expected on the reagent strip?
bilirubin
Which of the following urine specimen is most useful when screening for glucosuria?
2-hour postprandial specimen
Which of the following correctly describes normal amniotic fluid when subjected to spectrophotometry?
Absorbance is highest at 365 nm and decreases linearly at 550 nm.
In which of the following conditions is urobilinogen present in increased amount in urine?
I. Malaria
II. Pernicious anemia
III. Cholelithiasis
IV.Congestive Heart Failure
V.Nephrotic Disease
VI. Infectious Mononucleosis
I, II, IV, VI
Which of the following structures are the functional units of the kidneys?
Nephrons
WBC casts are most likely indicative of which of the following disorders?
pyelonephritis
All of the following are causes of inflammatory joint disorder EXCEPT?
Osteoarthritis
While performing analysis of the baby’s urine, the medical technologist smelled its “mousy” odor. Which of the following substances could be excreted in urine that
produces the characteristic “mousy” odor?
phenylketones
What is a semen analysis?
routine test for infertility
Which of the following conditions refers to presence of intact red blood cells in urine?
hematuria
Generalized loss of proximal tubular function is a characteristic of which of the following renal disorder?
Fanconi Syndrome
Based on your experience, why is it best to open both eyes during microscopic examination?
To avoid eyestrain
Laboratory findings of the blood & urine specimens from an 80-year old man diagnosed of chronic renal failure are as follows:
24-hour urine volume: 1000 mL; serum creatinine: 2.0 mg/dL; urine creatinine: 200 mg/dL
With these findings, what is the calculated glomerular filtration rate (GFR) of the patient assuming that his body surface area is within normal limits?
69 mL/min
Based on what you had learned, what were those white precipitates formed when urine was mixed with Sulkowitch reagent?
calcium oxalates
Which of the following substances are the primary chemical constituents of a normal urine?
water, chloride, urea
Which of the following chemical tests is most frequently performed on synovial fluid?
glucose
Which of the following pairs of analyte and renal diseases is correctly matched?
: ketones – diabetes mellitus
What graph is used to plot absorbance difference at 450 nm and gestational age to assess the severity of hemolytic disease of the newborn?
Liley graph
Which of the following correctly describes a Reiter cell?
Vacuolated macrophage with ingested neutrophils
What are the three renal functions?
Filtration
Reabsorption
Secretion
Where does water reabsorption take place in the nephron?
PCT and DCT
Where does reabsorption of glucose take place in the nephron?
PCT
Which hormone controls reabsorption of water in the distal tubules?
Antidiuretic Hormone
Which hormone controls reabsorption of sodium?
Aldosterone
Measurement of the number of solute particles per unit of solvent, irrespective of molecular weight?
Osmolality
What is widely accepted as the best overall measure of kidney function?
Glomerular Filtrate Rate
Name a test that is commonly performed to estimate the glomerular filtration rate
Creatinine Clearance
What is the preferred specimen for routine urinalysis?
First Morning Specimen
Ideally, how soon after collection should a urine specimen be tested
Within 1-2 hours
It a measurement of the dissolved solute in the urine and reflects the concentrating ability of the kidneys
Specific Gravity
Which substances contribute most to specific gravity of normal urine?
Urea and Sodium Chloride
What is normal specific gravity a random urine?
1.001-1.035
What is normal specific gravity of a 24hr specimen?
1.015-1.025
Urine specific gravity is less than 1.010
Hyposthenuria
What is another name for the refractometer?
Total Solid Meter
How does the refractometer measure specific gravity?
By refractive index
Increased urine production
Diuresis
Urine production over 2000 mL per day
Polyuria
Urine production less than 500 mL per day
Oliguria
No urine prodcution
Anuria
How is thee volume of urine produced affected by diabetes mellitus?
Increased
How is the volume of urine produced affected by diabetes insipidus?
Increased
What is responsible for the color of normal urine?
Urochrome
What might cause the urine to be almost colorless (straw)?
Dilute urine
What might cause the urine to yellow-green?
Bilirubin oxidized to biliverdin
When is melanin present in the urine?
Metastatic Melanin
What might cause the urine to be black or brown?
Homogentisic acid
Melanin
When is homogentisic acid present in the urine?
Alkaptonuria
What might cause the urine to be port wine colored?
Porphyrins
What might cause the urine to be smoky in appearance?
Red Blood Cells
What might cause the urine to be cloudy?
White Blood Cells
What causes a fruity odor in urine?
Ketones
How does a vegetarian diet affect the urine pH?
Alkaline urine
Which protein does reagent strip detect?
Albumin
Which proteins are detected by the acid precipitation test for protein?
Albumin
Bence Jones Proteins
Which acid is commonly used to precipitate urine protein?
Sulfosalicylic Acid
Present in the urine patients with multiple myeloma and Waldenstrom’s macroglobulinemia?
Bence Jones Proteins
A benign proteinuria most commonly seen in young adults. It is characterized by protein in urine after standing.
Orthostatic Proteinuria
What reagents are used in the glucose test on the reagent strip?
Glucose oxidase/peroxidase
Which sugar does the reagent strip detect?
Glucose
A defect in the renal tubules’ ability to reabsorb glucose?
Renal Glucosuria
Which is more sensitive for glucose, the reagent strip or copper reduction test?
Reagent Strip
What reagent is used to detect ketones on reagent strip?
Sodium Nitroprusside
Laboratory tests for ketones are usually most sensitive to which ketone?
Acetoacetic Acid
What reagent is used to detect bilirubin on reagent strip?
Diazonium Salts
What is the significance of a positive urine bilirubin?
Hepatic or post-hepatic jaundice
Which type bilirubin can be excreted in the urine?
Conjugated/Direct Bilirubin
A positive urine bilirubin with a negative urobilinogen is suggestive of what condition?
Obstructive Jaundice
What us the preferred specimen for a urine urobilinogen?
2 hour specimen collected between 2-4pm
What reagent is used to detect urobilinogen in the quantitative test?
Ehrlich’s reagent
How should a specimen for urobilinogen be stored?
Dark container
Which substances in the urine are light sensitive?
Bilirubin
Urobilinogen
What is the significance of a positive urine leukocyte esterase test?
Urinary Tract Infection
What are the most reliable indicators of renal disease?
Proteinuria
Casts
The colorless precursor of the porphyrins?
Porphobilinogen
A rapid method to detect porphobilinogen that does not require a separation phase?
Hoesch Test
Which hormone in the urine is indicative of pregnancy?
Human Chorionic Gonadotropin
At what pH are the formed elements best preserved in urine?
Acid
Which stain can be used for urine sediment examination?
Sternheimer-Malbin
In urine sediment examination, which elements are reported per high power field?
RBC
WBC
The presence of white blood cells in the urine?
Pyuria
Which type of white blood cells are seen most frequently in the urine sediment with urinary tract infection?
Segmented Neutrophil
WBCs whose granules demonstrate Brownian movement?
Glitter cells
What is the significance of crenated RBCs in the urine sediment?
Hypertonic urine
RBCs that have lost their hemoglobin?
Ghost cells
What protein is found in all casts?
Tamm Horsfall protein
A hyaline cast with a tapering end?
Cylindroid
What is the clinical significance of WBC casts in the urine sediment?
Pyelonephritis
What is the clinical significance of RBC casts in the urine sediment?
Glomerulonephritis
What is the clinical significance of epithelial cells in the urine sediment?
Renal tubular damage
What is the clinical significance of fatty casts in the urine sediment?
Nephrotic Syndrome
What might cause casts to dissolve?
Alkaline urine
Most often yeast seen in urine sediment?
Candida Albicans
Which crystal is the only needle found in alkaline urine?
Calcium Phosphate
Name two crystals that are seen in the urine with severe liver disease?
Leucine
Tyrosine
What is the clinical significance of cholesterol crystals in the urine sediment?
Nephrotic syndrome
Which urinary crystals are birefringent?
Calcium oxalate
A form of stored iron
Hemosiderin
Accumulation of a large amount of fluid in a cavity?
Effusion
Accumulation of fluid in the peritoneal cavity?
Ascites
An effusion due a systemic disease process
Transudate
An effusion due a inflammatory process within the body cavity
Exudate
When might blasts be seen in CSF
Acute lymphocytic or Acute myelogenous leukemia
Collection of synovial fluid, a normal joint does not have enough fluid for aspiration?
Arthrocentesis
Neutrophils with small, dark cytoplasmic granules consisting of precipitated rheumatoid factor
Ragocytes
What disease is diagnosed by a high amniotic fluid bilirubin?
Hemolytic disease of the newborn
A protein in cervicovaginal secretions of pregnant women that is used to assess the signs and symptoms of preterm labor?
Fetal Fibronectin
What must occur before semen analysis can begin?
Liquefaction
How soon after receipt should semen be evaluated for sperm motility
Within 1hour
What reagents are used to test for occult blood in feces?
Orthotoluidine
Guaiac
Excess fecal fat caused by poor fat absorption in the intestine?
Steotorrhea
On what organ is angiotensin 1 converted to angiotensin 2
Lungs
Aldosterone is one of those hormones whose production is stimulated upon activation of the RAA system. It is responsible for the reabsorption of what substance
Sodium
TRUE OR FALSE
Tubular reabsorption refers to the passage of essential substances from the tubules to the blood for them to be re-circulated in the body
True
Glomerular filtration tests like creatinine clearance are reported in what unit of measurement
mL/min
TRUE OR FALSE
Majority of glucose reabsorption happens in the distal convoluted tubules
False
TRUE OR FALSE
In acidotic blood conditions, hydrogen ions are secreted in exchange for reabsorption of sodium and bicarbonate ions
True
Low sodium level in our body could lead to
___ water retention
Low
The cellular structure of the glomerulus is composed of three layers. _____ refer to the intertwined foot process of the inner layer of the bowman’s capsule
visceral epithelium
TRUE OR FALSE
Sodium is passively reabsorbed in the descending loop of henle
False
Which of the following tests is used to assess tubular reabsorption?
Specific gravity
The glomerulus is surrounded by a structure called the
Bowman’s capsule
Which of these urinary structures is not involved in the countercurrent mechanism
Juxtaglomerular apparatus
TRUE OR FALSE
Renal threshold of glucose is around 160-180mg/dL
True
TRUE OR FALSE
The walls ascending loop of henle is impermeable to water
True
All of the following prevent albumin and other proteins from entering the glomerulus except for
Basement membrane
Normal renal blood how counts for
1200mL/min
The glomerulus serves the filtering apparatus of the nephron. The glomerular filtration barrier composed of
capillary endothelium, podocytes, basement membrane
Glomerular filtration test are corrected if we have dealing with body that vary greatly,
From the average body size of ___ m2
1.73
TRUE OR FALSE
Color indicates the presence of particulate matter in urine
False
Indicator for alkaline pH/reaction in the urine strip
Red
What will happen to the urine specific gravity of a little boy who keeps running?
Increased
Indicator for acidic pH/reaction in the urine strip
Blue
What will happen to the urine specific gravity in patients with End Stage Renal Disease?
Increased
Which of the following organizations publishes
guidelines for writing procedures and policies in
the urinalysis?
CLSI
An acceptable disinfectant for decontamination of blood and body fluid
Sodium hypochlorite
Centrifuging an uncapped specimen may produce a biological hazard in the form of:
Aerosols
n automated urinalysis, the specific gravity is measured by:
Refractometry
